Thalidomide

Thalidomide (C₁₃H₁₀N₂O₄; phthalimido-glutarimide; one of a number of systematic names is 2-(2,6-dioxo-3-piperidinyl)-1H-isoindole-1,3(2H)-dione) is a sedative and hypnotic drug that was sold during the 1950s and 1960s as a sleeping aid and to pregnant women as a antiemetic to combat morning sickness and other symptoms.

The drug was synthesized at Chemie Grünenthal in West Germany in 1953. It was marketed from October 1, 1957 mainly in Germany and Britain and was available in around fifty countries, although not in the USA, under at least forty different names (such as Talimol, Kevadon, Nibrol, Sedimide, Quietoplex etc).

It was later (1960-61) found to be teratogenic in fetal development, most visibly as a cause of amelia or phocomelia as the drug is a angiogenesis inhibitor - interfering with blood vessel development, especially if taken during the first 25 to 50 days of pregnancy. Around 15,000 fetuses were damaged by Thalidomide.

The drug is most toxic if taken orally and is a mild carcinogen. Other symptoms can include peripheral neuritis, numbness, paresthesias in the extremities, peripheral neuropathy, mental confusion, unsteadiness, hypotension, and absent reflexes. Excessive dosages can lead to pulmonary oedema, atelectasis or aspiration pneumonia, and refractory hypotension.

Thalidomide was banned for its intended use but it has been found to be effective elsewhere and is currently (2001) undergoing clinical trials with the name Thalomid(R): as a antineoplastic agent, in the treatment of leprosy symtoms (ENL, erythema nodosum leprosum), in HIV related symptoms by reducing inflammation (blocking Tumor Necrosis Factor (TNF)), for advanced multiple myeloma, prostate cancer, and glioblastoma.